23D-050 (6) vLAN
iiiipro-,o �• City of Northampton REQUIRED INSPECTIONS
A �emir.. �;5i
*ti1, ,,,; 74 r I. Footings and Walls
•� 1. �= BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
Office of the Building Inspector
No. 884
Zoning Form No. 962786 Date 9/18/97 Fee $20.00 Check# 983
Page, 23D Parcel 50 Zone i1RB Section 127 ❑ Yes 0 No
BUILDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT before Building Inspections
strip & reshingle roof
has permission to Inspection on Site—Foundations
situated on 89 Riverside Dr - Peter Flynn Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors(Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON TH PREMISES
w
Certificate of Occupancy 1", -- -4: e�t
Bui ding Inspector
Vi i� her , .,.�
U
Ili
SEP 161997 U°" FILE # �? .� , 6 gg9
APPLICANT/CONTACT PERS I N: 7 i 4'l J 71,gGc-fizeui Ito e°°r
DEPT GADDRESS/PHON : 697 . ,_,. : toi L (a --/a 93
PROPERTY LOCATION: g/ (-04_r' `,p ti
MAP )3 D PARCEL: t SQ ZONE ,,t/)J -
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
7CINTNCT FORM FILLED ()TTT 1./
Fee Paid
Building Permit Filled out t_...-
Fee Paid 9g3 U Type of C'nnctructinn•
New Rem Construction '/��r� 2�i/ ,�-�
Remodeling interior
Addition to Existing
Accessory Structure
Building Plane Inelnded•
Owner/Occupant Statement nr T reuse DeV 51(04?O L.----""
3 Sets of Plane /Plot Plan _
THFrFOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
' Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received& Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
—,„ . frr� utlyefv •
' nAr P� on
, 74/9:2
Signature of Building ..sector Date
NOTE: Issuance of a zoning permit does not relieve an epplioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
r 0 1 MI [1 W gift")
IJ{1I SEP 161997 k IiJ
DEPT OF BUILDING INSPECTIONS Fi le No. 9f a 2Rto
NORTHAMPTON MA C1060
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
)1. Name of �` f
Applicant: C�r�uS V:vJ vh z� /A/�W►Mgh S l��5 `•
Address: 69)' ' 2,•0. L �c1 . Telephone: 5-76 —/0 4
2. Owner of Property: " kL 6..2 I y,N iJ
Address: Pel .ii,,( ;t e 2, Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): 't 1/12c..c' ,- I
4. Job Location: 77 -fait{4 $ ,� f vim, /V e)V2ACt b brT‘st)h
Parcel Id: Zoning Map# W.? Parcel# District(s): ...-QA-
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) -
5. Existing Use of Structure/Property S;c�. \6 � 7),,,..)el
- o ;,A (2)
%1..(1- -
6. D cription of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): •
7 —(arn O t—
s-VrNi). IhI 5—C': a �l 1 0- fls c V,c\A
�S 1 h
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW X YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book _ Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO , k, DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
10, Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pa.ved parking)
# .pf -Parking Spaces
#- fof Loading Docks
Fill:
-(voI-ume -& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
1
DATE: 9 /6 /7 APPLICANT's SIGNATURE
NOTE: Ism ano of a zoning permit does not relieve an appl" ants burden to oompiy with all
zoning requirements and obtain all required permits from t e Board of Health, Conservation
Commission, Department of Publio Works end other applio ble permit granting authorities.
FILE
E m wg 11
4. ti' SEP 161997 0.ii r of Thzfljantpfan I =*-
.*:� ,f$lasaar}Inaetts �`-'�'_
'"-. DEPT OF BUILDING INSPECTIONS =�f—
'- NORTHAMPTON MA 01061' D&PtARTMENT OF BUILDING INSPECTIONS _`-_r` _
a1=�=
212 Main Street a Municipal Building
Northampton, Mass. 01060 tti .,
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, CA] rv' NPujrvvl n
(licensee/permittee)
with a principal place of business/residence at:
t.fin- '3, ,rice re 6• (phone#) 5P)LL - (Uq 3
(I,utxt/city/start ip)
do hereby certify, under the pains and penalties of perjury, that:
Qq I am an employer providing the following worker's compensation coverage for my
employees working on this job:
EaSsrn Cam14yy .irS . CU . LOLVLYVAe))3 — 5\I- - laP5
(Insurance Cow}') (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if necessary to indude information pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself
NOTE:please be aware that while homeowners who ecaploy person to do maintenance,oomtructioo or repair work on a dwelling of
not more than throe units is which the homeowner resides or on the grounds appurtenant thereto are not generally considered to be
employers under the worker's compensation Ad(GL152,ssl(5)),application by a homeowner fora Grease or permit may evidence the
legal status of an employer under the Worker's Connpeceation Act.
I understand that a Dopy of this statement may be forwarded to the Department of Industrial Accidents'Ol;ioe of Insurance for the
coverage verification and that failure to wane coverage under section 25A of MOL 152 can lad to the imposition of criminal penalties
consisting of a fine of up to S 1,500.00 and/or mprisoomm2 of up to one year and cavil penalties in the form of a Stop Work Order and a
fins of 3100.00 a day against ma
Signed this 1 6 day of 5ti7+" , 199 7 For dmar4mmtal use only
Permit Number
Map# Lot#
Signature icensee/Permittee
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
akr:r NORTHAMPTON, MASS. 19 Additions
� %4� APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location < 9 '�1 0 f teS rt D ` J 12• ,`,a 42kArr-1 MRL1J Lot No.
2. Owner's name 4)j A-r►2 'El.?, Al 1s(£ �i Address &kw, rr
3. Builder's name C y aos h„, f w vh4 v.‘ Address 6C-7 Id 2ck_,C )vd ,,,,e h
Mass.Construction Supervisor's License No. C 5 0 4-4 670 Expiration Date y///9 q
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines -
12. Type of roof 6 a i ! E •'sTc J\ 12Dc���vl 1 (15 �` (�5?\14\+- S`n,,--;I t 5
13. Siding house V
14. Estimated cost:- (-006 o�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and beli f.
Signature of responsible appicant
1
Remarks L -E0O F (pA id .P I kc,usf
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